Watch Thomas Lamperti, MD Perform Lower Lateral Crural Overlap During Open Rhinoplasty Surgery To Improve Tip Rotation and Bulbosity
Seattle Facial Plastic Surgeon, Thomas Lamperti, MD, narrates the his latest operating room video in which he demonstrates how to perform lower lateral crural overlap during open rhinoplasty surgery.
"This is Seattle facial plastic surgeon, Dr. Thomas Lamperti. Today I'm going to show you how to perform lower lateral crural overlap during open rhinoplasty surgery. To start you can see that I’ve already exposed the nasal tip cartilages. Now I’ll incise across the right lower lateral crura. I’m carefully making this incision to prevent cutting through the underlying vestibular mucosa.
I’ll now dissect the skin lining on the undersurface of the cartilage. This will allow me to ultimately overlap the cartilage more freely without having bunching of this skin lining. I’m undermining the skin lining underneath both segments of cut lower lateral crura. Once I’ve adequately mobilized the cartilage I’ll now overlap the edges to effectively shorten the lower lateral crura. To prevent contour deformities it’s important to place the anterior segment over the posterior segment.
I’ll now use a 5-0 nylon suture to secure the cartilage in position. I typically place a suture on both the cephalic and caudal edges. I do this to maintain proper support and prevent future shifting or pivoting of the cartilage. Once I’ve completed the suturing on the right side I’ll the process on the left side. The end result is a slightly more rotated nasal tip. Additionally, lower lateral crural overlap helps treat cartilage convexity and tip bulbosity as well."